Binge Drinking and a Minimum Price for Alcohol

Ironically, the 'hard drugs' we warn our children about before they hit the town kill far fewer people than alcohol or nicotine, substances which pose bigger threats to their long term health.
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Our muddled approach to teenage drinking is in marked contrast to the consistent tough stance we adopt when warning the young about the perils of 'hard' drugs. Lecturing teenagers on the evils of alcohol while peddling it to them for half nothing sends them the wrong signal.

In a recent survey, published ahead of Alcohol Awareness Week, most 16-24 yr olds who were interviewed agreed that low cost encourages excessive drinking.

On a similar note Alcohol Health Alliance, in a letter to the Sunday Times, called on government to impose a minimum price of 50p per unit to curtail the damage cheap liquor is doing to many of these youngsters.

It should know. Its members are health professionals up and down the land and have first hand experience of dealing with the damage binge drinking does to youthful revellers every Friday and Saturday night.

Ironically, the 'hard drugs' we warn our children about before they hit the town kill far fewer people than alcohol or nicotine, substances which pose bigger threats to their long term health.

Crack, speed, heroin, nicotine and alcohol all come from the same stable. They work differently but they are psychoactive drugs. They make us happy or 'euphoric' in small doses but in larger ones they are poisons and can kill, something they do with alarming regularity.

On a richter scale equivalent of deaths from drug use at any age nicotine is in a class of its own, accounting for over a 100,000 a year in the UK. Alcohol is some way behind at under 9000, with many more being indirectly attributable to its misuse.

Hard drugs like heroin, cocaine, methadone and amphetamines are further down the scale -less than 2000 deaths in England and Wales in 2011- but with no less tragic a circumstance behind each individual fatality.

Hardly registering at all is cannabis which, in its overall impact on society, could be regarded as a modest interloper compared to the rest.

But official figures tell only part of the story. Cannabis does kill - how many we do not know - and abusers are at increased risk of becoming psychotic or developing mental illnesses, heart attacks or lung diseases, lower IQs and cancers and of killing themselves or others if they drive while under its influence.

There are no safe recreational drugs and that includes alcohol.

Indeed, our skewed perception of which substances constitute the biggest threat to society can be compounded by the publicity given to high profile deaths from hard drug abuse, especially where a celebrity is tragically involved, while then ignoring the frequent but no less tragic deaths among ordinary youngsters when alcohol is the sole or important contributory cause.

Accidents, pranks that go wrong, fights, assaults, road traffic accidents, poisonings from binge drinking, drownings, fires, choking while unconscious and suicides are all personal disasters commonly associated with alcohol misuse and binge drinking amongst the young.

Incidents like these kill up to 5000 under 21-year-olds in the US each year. In the UK many hundreds of young people die in equally tragic circumstances. They are an important and largely avoidable cause of death at an age when deaths are fortunately rare. And all of this before the full health effects of excessive drinking, like liver cirrhosis, starts to notch up their inevitable toll.

Adolescents who binge drink are at greater risk of meeting such a fate, and downing more BOGOFs from supermarkets or promotional deals commonly offered by pubs and clubs than they need on stomachs full of beer certainly can't help.

The dangers of overdosing on high strength alcohol, with the obvious risks this entails, are commonly underestimated by naive young drinkers. The margins between the quantity of alcohol needed to give a buzz, stupify and kill is not as wide as many drinkers imagine. It is more likely to be breached when hard liquor is downed with gusto.

Cheap alcohol is a controllable factor which predisposes young drinkers to overdosing.

Educating young people (the vast majority are not addicted and will learn) about the immediate and long term health effects of excessive drinking, on what the different strengths mean and why downing strong liquor too quickly spoils an otherwise good evening, will each have an impact on sensible adolescents who want to have a good time.

In a study of 28 community focus groups published by BMC Public Health the majority felt that education, more than setting a minimum price for alcohol, would help alleviate the problems of binge drinking.

The evidence on minimum pricing and its effect on excessive drinking by young people in particular is considerable, however. It merits inclusion as a priority in any plan for tackling excess and binge drinking, both being risk factors for longer term dependence. Good intentions or voluntary codes on advertising, marketing and promotions, important as they are, do not obviate the need for sensible pricing strategies.

There is no one solution to fixing a culture of drinking that poses immediate and long term threats to the well being of a generation. But you have to start somewhere.

Those now calling for minimum prices might, in some revellers' eyes, be spoilsports. But they are just being pragmatic.

Alcohol is still a drug like any other and placing it beside the milk and water on supermarket shelves, and pricing it to match, won't change that.

Dr Brogan has trained and practices in addiction management, specialising in smoking cessation techniques.